Autotraction versus passive traction: an open controlled study in lumbar disc herniation

Autotraction (AT) is a treatment for low-back pain syndrome of benign etiology that uses a specically designed traction table divided into two movable sections. While lying on the table, the pelvis secured, the patient controls the traction forces by grasping and pulling the bars at the head of the table. There are controls for the therapist to apply, through movable sections of the table, rotation and bending forces to help restore mobility to the lumbar spine without inducing pain. The present study is based upon a randomized treatment trial comparing conventional passive traction (PT) to AT. The following outcome indicators were used: (1) subjective response concerning overall improvement, (2) pain intensity (visual analog scale, 0-100), (3) qualitative pain severity (McGill Pain Questionnaire, short-form, 0-45), and (4) pain related disability (Oswestry Low Back Pain Disability Score, 0-100). The favorable response to AT was 75% (30 of the 40 patients) versus the 22% (6 of 27 patients) to PT (p < 0.001). After 3 months, 19 of the 30 responders to AT (63%) reported continued improvement. In these patients, pain ratings remained stable and the disability scores decreased to 0 to 23% of the pretreatment value (median and mean respectively, p < 0.001).